{
"Npi": {
"NPI": "1083168512",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "NORTHWEST SMILE DENTAL AND DENTURE",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "7233 MARTIN WAY E",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "OLYMPIA",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "98516-5534",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "360-489-0991",
"MailingAddressFaxNumber": "360-915-6214",
"FirstLinePracticeLocationAddress": "7233 MARTIN WAY E",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "OLYMPIA",
"PracticeLocationAddressStateName": "WA",
"PracticeLocationAddressPostalCode": "98516-5534",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "360-489-0991",
"PracticeLocationAddressFaxNumber": "360-915-6214",
"EnumerationDate": "08/12/2016",
"LastUpdateDate": "08/12/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BEALE",
"AuthorizedOfficialFirstName": "YOUNI",
"AuthorizedOfficialMiddleName": "CHO",
"AuthorizedOfficialTitle": "DENTURIST",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.P.D",
"AuthorizedOfficialTelephoneNumber": "360-489-0991",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QD0000X",
"TaxonomyName": "Dental Clinic/Center",
"LicenseNumber": "604003708",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}